II. Approach: General
- Help students understand the rotation
- Distribute a written overview at the start of the rotation (and review with students)
- Include focus areas, core concepts and expectations
- Learn about the students and find common ground
- Career goals
- Prior rotations and experiences
- Specific topics of interest (might lead to presenting a paper or short presentation during rotation)
- Student's Perception of their strengths and the areas they need to improve
- Give feedback throughout the rotation
- See the one minute preceptor below
- Give feedback in a private, safe setting
- Reinforce positive habits
- Focus on quality feedback (rather than quantity, or a generic "great job")
- Keep the feedback as a 2-way collaborative conversation (as opposed to a 1-way lecture)
- Timing
- Give short, specific feedback each focused on a single teaching point for a few minutes daily
- Consider a weekly feedback wrap-up (e.g. Fridays), and discuss next steps
- Final evaluation should reflect the cummulative feedback given during the rotation
- Learner feedback to the preceptor
- What could I have done differently?
- What would you change about this rotation?
- Help learners accept feedback and manage emotions
- Give constructive feedback and listen to the learners perspective
- Normalize mistakes as part of the learning process
- Share your own prior mistakes with the learner
- Treat Students as Colleagues
- Share how do you balance your work and life
- Find common ground
- Share your own challenges to build trust
- One Minute Preceptor
- Student commits to a diagnosis or clinical syndrome ("What do you think is the cause?")
- Student presents supporting evidence ("Why do you think this is the cause and what was your DDx?")
- Teach General Rules that apply to the specific diagnosis (core concepts, pearls, or strategies)
- Reinforce what was right
- Correct mistakes
- Encourage self assessment
- Based on clear goals and expectations explained at the begining of the rotation, and reinforced throughout
- How do you think that went?
- What went well?
- What were your challenges?
- Review their self assessment
- Validate or correct their self assessment
- Distribute the teaching (for the student's experience and for the preceptor's time)
- Medical residents Teaching Medical Students
- Following the patient's care with a consultant (e.g. surgery of an emergency department patient)
- Shadowing another provider to see a patient with an interesting presentation
- Experiencing the front desk, nursing triage, rooming of patients, lab, imaging
III. Approach: Pearls
- Dispell myths
- Perfectionism
- Perfect impedes completion, breeding procrastination and paralyzing progress
- Strive for reasonable results that are completed in budgeted time
- Multitasking
- Multitasking decreases productivity and introduces more errors
- Apply appropriate, focused attention to important individual tasks, one at a time
- Imposter Syndrome
- High achieving students feel anxiety, stress, self-doubt, and underachievement despite the contrary
- Facilitate learners appreciate their accomplishments, competence, strengths through self-reflection
- Learners (as well as preceptors) are not expected to know everything, and attendings also make mistakes
- Encourage learners to accept positive feedback as real
- Consider counselors or employee assistance programs (EAP) for more refractory, persistent feelings
- Clance Imposter Phenomenon Scale
- Perfectionism
- Efficiency
- Schedule on a calendar, focused time for a single important task
- Eliminate distractions (phone messages, email)
- Maintain a To-Do list
- Perform taks in cycles (e.g. Pomodoro Technique)
- Focus on an intended task for a specified period (e.g. 25 minutes) of time
- Take a break after the allotted time (e.g. 5 minutes)
- Organization
- Prioritize tasks on a To-Do List
- Perform Urgent and Important tasks first
- Perform short important tasks (<5 min)
- Perform Non-Urgent but important tasks
- Unload non-important tasks (does this need to be done at all?)
- Consider project management software for longterm or complex projects (e.g. Trello)
- Seek early and regular feedback to avoid unnecessary work and detours
- Prioritize tasks on a To-Do List
- Start-Stop-Continue Feedback Method
- One habit to START doing
- Example: Verbalizing a prioritized differential diagnosis early in the presentation
- One habit to STOP doing
- Example: Reading through exhaustive, non-contributory raw patient data
- One habit to CONTINUE doing
- Example: Structuring clinical assessments using a clear, organized format (e.g. SOAP)
- One habit to START doing
- SMART Framework Method for a clear learning plan
- SPECIFIC Change to make defined
- MEASURABLE in an uncomplicated way
- ACHIEVABLE during the rotation
- RELEVANT to the experience
- TIME-bound with a deadline
IV. Resources
- One Minute Preceptor (Dr. Margaret Dow, Mayo Clinic)
- 1 Minute Preceptor: Precepting Medical Students (Dr. Michelle Rodriguez)
- Tips To Being an Effective Preceptor (Dr. Paul Paulman)
V. References
- (2022) Presc Lett 29(7): 41
- (2024) Presc Lett 31(5): 27
- (2024) Presc Lett 31(7): 38-9
- (2026) Presc Ins 33(8): 6